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Surgery ends five-year ordeal for chronic migraine sufferer

Every day for five years, Stacy Cook closed the curtains of her Southeast Texas home and retreated into the darkness.

Even then, the headaches followed her.

Stacy Cook

“I couldn’t get away from the pain,” she said. “It was like a knife going deep into my temple.”

The 32-year-old mother tried a variety of treatments, including medications and steroid injections, but the pain would not go away. When she had to go outdoors, she hid behind dark sunglasses and under a hoodie. Most of the time, she stayed inside.

“The thought of facing the sunlight was too scary,” Mrs. Cook said. “It took all the strength I could muster to go outside.”

She had reached her breaking point when she heard about a relatively new type of migraine surgery being performed by physicians at UT Southwestern Medical Center. An online search led her to Dr. Bardia Amirlak, Assistant Professor of Plastic Surgery.

The surgery has helped migraine and chronic headache sufferers by pinpointing trigger points that lead to severe headaches, Dr. Amirlak said.

The treatment involves using Botox or nerve blocks to detect trigger sites that compress, irritate, or entrap nerves, which can cause migraines or chronic headaches. If the Botox or nerve block lessens the pain, surgery to decompress the targeted nerve should be considered as the next step, Dr. Amirlak said. In some cases, surgery works even when the patient does not respond to Botox.

The majority of migraine patients are candidates for this outpatient surgery, Dr. Amirlak said. The procedure involves severing tiny muscles and other tissues pressing on and irritating heachache-trigger nerves. The incisions are hidden beneath the forehead hairline and behind the nape of the neck.

The results are long-lasting, with 90 percent of patients experiencing a significant benefit from surgery, Dr. Amirlak said. In 60 percent of cases, he said, the headaches are completely eliminated.

Most people who opt for the procedure have not responded to other treatments or have experienced significant side effects from medication.

Mrs. Cook suffered from new daily persistent headache (NDPH), a variant of chronic headache that starts suddenly and causes chronic continuous pain, Dr. Amirlak said. She also had classic migraines.

After a consultation with Dr. Amirlak, Mrs. Cook decided to have the procedure, which takes less than 90 minutes, in December.

The day after surgery, Mrs. Cook said, she woke up for the first time in five years without a throbbing headache. Although she felt some discomfort from the incision, it was nothing like what she usually experienced.

When she returned to her home in Montgomery, a Texas town about 55 miles north of Houston, her husband asked if he could open the curtains, just a crack.

“I told him to just go ahead and open them,” she said. “For the first time, light didn’t seem unbearable.”

Since the surgery, Mrs. Cook has been able to go outdoors for a walk or play ball with her children, Liam, 9, Graham, 7, and Cameron, 5.

The family recently celebrated with a vacation to Disneyland, an experience that would have been unimaginable before the surgery.